Inflammatory Bowel Disease Day

The 19th of May is World Inflammatory Bowel Disease day. The Gut Foundation increases community awareness of the occurrence of inflammatory bowel disease (IBD) in Australia. More than 75 000 people experience IBD in Australia, with most people diagnosed between the ages of 15 – 30 years, however IBD can occur at any age, with an increasing number of children under the age of nine being diagnosed with Crohn’s disease.

What is IBD?

Inflammatory bowel disease is a collective term to describe two chronic inflammatory bowel conditions; Crohn’s Disease and Ulcerative Colitis

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Crohn’s Disease

Crohn’s Disease may affect any part of the digestive tract, however most often occurs in the terminal ileum (the last part of the small intestine) and the large intestine. Incorporating the entire wall of the intestine, this inflammatory disease can lead to significant damage to the cells of the intestinal wall, the formation of fistulae (passage between one part of the bowel to other part of bowel) and strictures (narrowing of the intestinal wall).

Ulcerative Colitis

Ulcerative colitis is an inflammatory condition of the small intestine, which affects the inner lining of the bowel (including the colon and rectum). The chronic inflammation of the bowel in Ulcerative Colitis can lead to the development of chronic ulcers in the lining of the large bowel and rectum.

What are the Symptoms of IBD?

• Diarrhoea (sometimes with blood or mucous).
• Abdominal pain, cramping.
• Bloating and flatulence.
• Nausea and vomiting.
• Reduced appetite.
• Weight loss.
• Fatigue.
• Malnutrition.
• Delayed or impaired growth in children.
• Anal fistulae, fissures and abscesses (in Crohn’s disease).

How do I know if I have IBD? Various testing can be performed by your local doctor or gastroenterologist to find out whether you have Ulcerative Colitis or Crohn’s disease such as blood tests, faecal (bowel motion) examination, x-rays, colonoscopy, gastroscopy, CT scan, MRI and ultrasound.

What causes IBD?

The exact cause of IBD is unknown, however an overactive immune response is hypothesised to be a contributing factor. A family history of IBD may also contribute, although this is not always the case.

Treatment:

Various pharmaceutical treatments are available for IBD that may reduce the chances of flare ups, reduce inflammation and the activity of the immune system. Surgery may be necessary in Crohn’s disease to repair fistulae and strictures. Surgery may also be utilised in Ulcerative Colitis, in extreme scenarios, to remove affected parts of the bowel.

Dietary management of IBD

People with IBD have difficulty digesting some types of food and often experience flare ups of their symptoms, which may be minimised through various dietary practices, depending on the individual sensitivity.

1. Limit dairy products – those with Crohn’s disease may be lacking the enzyme to break down the lactose found in dairy products, as this is produced in the lining of the small intestine. Therefore consuming lactose containing dairy products may be problematic.
2. Reduce amount of fat – again, those with Crohn’s disease affecting the small intestine may have difficulty digesting fats, which may worsen diarrhoea. Avoiding butter, cream, oily and fatty fried foods would be desirable.
3. Watch your fibre – Fibre can be a problematic food for IBD sufferers, particularly in those with Crohn’s who have narrowing of the intestine. Raw fruits or vegetables can be replaced with steamed, baked or stewed fruits and vegetables.
4. Avoid stimulating foods – stimulating foods such as chilli, coffee and alcoholic beverages should be avoided, as they can worsen diarrhoea.
5. Eat smaller meals – eating smaller amounts of food at a time may reduce the burden on your digestive tract. Try eating 5-6 small meals instead of 3 main meals per day.
6. Drink plenty of water – as frequent passing of bowel motions and diarrhoea can result in dehydration.
7. Dietary advice – Seek out a Naturopath or Nutritionist in your local area, to prepare a dietary plan specifically tailored to your food sensitivities and needs.

Vitamin & Mineral Supplementation

People with IBD may have issues absorbing some vitamins and minerals, particularly Vitamin B12. Regular blood tests should be performed to monitor levels of Iron and Vitamin B12. Supplementation with Vitamin B12 may be necessary if deficiency is present, through either B12 spray or injections. A multi vitamin may also be of assistance, particularly in children with IBD, to ensure they are receiving adequate amounts of vitamins and minerals for growth and development. Calcium and Magnesium may also be helpful in people with IBD, experiencing frequent diarrhoea, as these minerals may be depleted.

These may also be of assistance….

1. Probiotics - increasing the amount of beneficial bacteria in the gut may improve digestive function in those with IBD.
2. Slippery Elm Bark – taking this herb may help to soothe and heal the gut.
3. Acupuncture – this treatment may be of assistance for those experiencing pain alongside their IBD symptoms.
4. Relaxation exercises and exercise – people with IBD often find their flare ups can be exacerbated during stressful times. Stress management techniques such as breathing exercise, meditation, yoga and exercise may be beneficial.